General
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● Use clinical staging only if the surgeon feels systemic regional lymph node sampling is not indicated or if the patient was treated with primary radiation therapy (record as cT, cN, cM)
● Otherwise use surgical / pathologic staging, assigned at the time of definitive surgical treatment or prior to radiation therapy or chemotherapy
● Stage should not be changed due to disease progression or recurrence or based on response to initial radiation therapy or chemotherapy that precedes primary tumor resection

Histopathology - Degree of differentiation:
● G1: 5% or less of a nonsquamous or nonmorular solid growth pattern
● G2: 6%-50% of a nonsquamous or nonmorular solid growth pattern
● G3: more than 50% of a nonsquamous or nonmorular solid growth pattern

Notes on pathologic grading:
1. Notable nuclear atypia, inappropriate for the architectural grade, raises the grade to 3
2. Serous, clear cell and mixed mesodermal tumors are high risk and considered grade 3
3. Adenocarcinomas with benign squamous elements (squamous metaplasia) are graded according to the nuclear grade of the glandular component

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